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General NPI Number Information
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NPI Number | 1477133494
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Entity Type | Organization
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Legal Business Name | WHITE GLOVES HOME CARE, LLC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 9160 FORUM CORPORATE PKWY STE 350
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City | FORT MYERS
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State | FL
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Zip | 33905-7808
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Country | US
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Telephone | 732-691-6027
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Fax |
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Provider Business Mailing Address
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Address Line | 3 HIDDEN VALLEY DR
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City | SUFFERN
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State | NY
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Zip | 10901-1301
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Country | US
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Telephone | 732-691-6027
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ELI KONOVITCH
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Credential |
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Telephone | 732-691-6027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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